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一例由严重 COVID-19 康复患者中发生的内源性假丝酵母菌眼内炎伴偶然巨细胞病毒感染和视神经病变。

A case of endogenous candida endophthalmitis with incidental cytomegalovirus infection and optic neuropathy in a patient recovered from severe COVID-19.

机构信息

Eye Unit, Teaching Hospital Kurunegala Sri Lanka, Sanjeewa Kaluarachchi-Consultant Vitreo-Retinal Surgeon, Muditha Abeykoon-Consultant Clinical Microbiologist, Teaching hospital Kurunegala, Colombo Road Kurunegala, Sri Lanka.

出版信息

Indian J Ophthalmol. 2022 Jan;70(1):323-326. doi: 10.4103/ijo.IJO_2454_21.

Abstract

A 62-year-old female diabetic recovered from COVID-19 pneumonia after receiving a prolonged course of steroids. She presented with a clinical picture of left-eye panuveitis with white cotton ball chorioretinal lesions and RAPD suggesting an optic neuropathy (VA HM). Diagnostic vitrectomy was performed to take samples for infective screen and to give intravitreal voriconazole empirically. Smear, culture, and PCR for viral DNA confirmed mixed infection of endogenous Candida endophthalmitis and incidental CMV infection. With further treatment, her corrected vision improved to 6/18 with regressing fungal lesions in serial fundus photographs. Prompt diagnosis and intervention preserved her vision and prevented potential life-threatening complications.

摘要

一位 62 岁的女性糖尿病患者在接受长期类固醇治疗后从 COVID-19 肺炎中康复。她出现左眼全葡萄膜炎的临床表现,伴有白色棉球状脉络膜视网膜病变和 RAPD,提示视神经病变(VA HM)。进行了诊断性玻璃体切除术,以采集感染筛查样本,并进行玻璃体内伏立康唑经验性治疗。涂片、培养和病毒 DNA-PCR 证实了内源性念珠菌眼内炎和偶然的 CMV 感染的混合感染。经过进一步治疗,她的矫正视力提高到 6/18,眼底照片上的真菌病变逐渐消退。及时的诊断和干预挽救了她的视力,防止了潜在的危及生命的并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4231/8917599/00ecac5a8605/IJO-70-323-g001.jpg

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